DEPARTMENT OF INSURANCE

Affiliations

Name	Mroz, Penny Lee	DOIID	331571	NAIC NPN	232416

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Non Resident	Agent	Casualty	8/15/2000	7/3/2014
Inactive	Non Resident	Agent	Health	5/20/2002	7/3/2014
Inactive	Non Resident	Agent	Property	8/15/2000	7/3/2014
Inactive	Non Resident	Agent	Life	5/20/2002	7/3/2014
Inactive	Non Resident	Agent	General Lines	3/18/1992	8/15/2000
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Bristol West Insurance Company	301655	Agent - Casualty	6/14/2011	7/3/2014
Inactive	Bristol West Insurance Company	301655	Agent - Property	6/14/2011	7/3/2014
Inactive	Chase Insurance Life and Annuity Company	300518	Agent - Health	5/20/2002	4/1/2007
Inactive	Chase Insurance Life and Annuity Company	300518	Agent - Life	5/20/2002	4/1/2007
Inactive	Farmers Insurance Exchange	300336	Agent - Casualty	1/22/2002	8/22/2012
Inactive	Farmers Insurance Exchange	300336	Agent - Property	1/22/2002	8/22/2012
Inactive	Farmers New World Life Insurance Company	300536	Agent - Health	6/13/2011	11/12/2012
Inactive	Farmers New World Life Insurance Company	300536	Agent - Life	6/13/2011	11/12/2012
Inactive	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Casualty	8/15/2000	7/3/2014
Inactive	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - General Lines	3/18/1992	8/15/2000
Inactive	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Property	8/15/2000	7/3/2014
Inactive	Foremost Property and Casualty Insurance Company	300871	Agent - Casualty	8/15/2000	7/3/2014
Inactive	Foremost Property and Casualty Insurance Company	300871	Agent - General Lines	3/18/1992	8/15/2000
Inactive	Foremost Property and Casualty Insurance Company	300871	Agent - Property	8/15/2000	7/3/2014
Inactive	Foremost Signature Insurance Company	300140	Agent - Casualty	8/15/2000	7/3/2014
Inactive	Foremost Signature Insurance Company	300140	Agent - General Lines	3/18/1992	8/15/2000
Inactive	Foremost Signature Insurance Company	300140	Agent - Property	8/15/2000	7/3/2014
Inactive	Northern Insurance Company of New York	301317	Agent - Casualty	11/22/2006	7/3/2014
Inactive	Northern Insurance Company of New York	301317	Agent - Property	11/22/2006	7/3/2014
Inactive	Protective Life Insurance Company	300638	Agent - Health	4/1/2007	12/20/2010
Inactive	Protective Life Insurance Company	300638	Agent - Life	4/1/2007	12/20/2010
Inactive	Truck Insurance Exchange	300335	Agent - Casualty	5/31/2007	8/22/2012
Inactive	Truck Insurance Exchange	300335	Agent - Property	5/31/2007	8/22/2012

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Foremost Express Insurance Agency Inc.	515334	Agent - Property	8/15/2000	3/3/2014
Inactive	Foremost Express Insurance Agency Inc.	515334	Agent - Casualty	8/15/2000	3/3/2014
Inactive	Foremost Express Insurance Agency Inc.	515334	Agent - Health	6/28/2002	7/3/2014
Inactive	Foremost Express Insurance Agency Inc.	515334	Agent - Life	6/28/2002	7/3/2014